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Why The Affordable Care Act Makes Us Want To Stay Abroad

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When it comes to health care, we quite honestly don't know what to think.

Or rather, we don't know what our health care strategy would be if we ever wanted to or had to go back to the U.S.

We have insurance now... excellent insurance, in fact. And even if we didn't, we wouldn't have to get U.S. insurance to avoid the new penalties under the Affordable Care Act. According to the IRS, U.S. citizens who live abroad at least 330 days of the year (like us) will be treated as if they have qualifying insurance coverage and won't owe any tax penalty... and that's true regardless of whether they actually have health insurance in the country where they live.

2013-11-11-healthierlifestyleoverseas.jpg

In many places overseas, not only is your health care more affordable, your lifestyle

can be healthier.

Photo courtesy of InternationalLiving.com

But the insurance we have is international insurance, and we would cease to qualify for it if we moved back to the U.S. Our plans right now don't include going back to the U.S., but life is what happens while you're busy making plans...

So we went to healthcare.gov to explore our options for health care plans under the new Affordable Care Act.

And could find out next to nothing.

We found that comparison shopping for health care plans under the new system is impossible without actually opening an account. We don't even know who this account is with... we assume it is with a government agency, but we have no idea which one.

But because we don't currently need U.S. insurance, we have no intention of opening an account in any case.

Which, we discovered, makes it impossible to compare the actual, final rates for various plans, because without an account, you can't see the specific figures for premiums adjusted for the number of family members or any discounts or tax breaks that might apply to any specific plan.

So we really have no idea exactly what health care in the U.S. would cost us in any particular location. However, we can tell, gleaned from the general plan premiums you can see at healthcare.gov without opening an account, that it almost certainly would cost us significantly more than we're paying now for comparable coverage outside the U.S.

Which doesn't surprise us. We can look up the rankings just as easily as anyone else, and we know that the U.S. has some of the most expensive health care on the planet.

We also know that, in study after study and index after index, the quality of U.S. health care rarely even breaks into the Top 10 compared to other countries around the world. The last study by the World Health Organization ranked the U.S. at 15th in overall performance and first in overall expenditure per capita. Combining the two factors put the U.S. in 37th place in the WHO study.

That was more than a decade ago, and the controversy over the findings was so great that the WHO declined to do such rankings any more. But a more recent Bloomberg study ranked the U.S. even lower when comparing price of health care to efficiency and quality of service... 46th in fact... the worst value for price in health care of any country in the developed world.

And in the time since both of these studies, we certainly haven't seen any general decrease in the cost of U.S. health care or any measurable improvement in its general quality or availability, even under the latest ministrations of the Affordable Care Act.

But that's just us, looking at things from abroad. Which, under the current health care circumstances in the U.S., is pretty much where we want to be right now.

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